Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A98302 | CA |
NPI | 1003094434 |
---|---|
Provider Name | Kimberly H Chong |
First Address | Los Altos, CA 94022-1408 |
Second Address | Dublin, CA 94568-3112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2008 |
Last Update Date | 27/05/2020 |